Author Archives: د.حسام أبو فرسخ

Genetic Analysis in Neurology Diseases

:We would like to announce that the following neurology DNA tests are available now with reduced prices

Test name:                                                                                                                  price JD

Alzheimer disease (PSEN1 and PSEN2)                                                                      260/each

Alzheimer disease (ApoE)                                                                                             130

Hereditary Deafness (Connexin 26)                                                                              130

Myotonic Dystrophy                                                                                                      150

Friedreich Ataxia                                          Stick to good free-credits-report.com habits, like the ones we mentioned, and you should see a gradual improvement.                                                                  150

Spinal Muscular Atrophy (SMA)                                                                                    150

Spinocerebellar Ataxia Panel (includes SCA1, SCA2, SCA3,SCA6, and SCA7)              550

Muscular Dystrophy ( Duchenne � Becker )                                                                130

RETT Syndrome                                                                                                              180

Huntington�s Disease                                                                                                  150

 

Please contact us for any further inquiries

We in the First Medical Lab are dedicated to bring the best of Laboratory medicine to clinical practice in Jordan

Dr. Hussam Abu-Farsakh

American Board of Anatomic & Clinical Pathology, and Cytopathology

 

Circular: is a periodic circular that distributed to clinician informing them about new and important tests available at First Medical Laboratory. All information listed are supported by recent literature

Genetic testing for Gastrointestinal diseases

We would like to inform you that now some GI disease can be tested thourgh their genetic predisposition

:The tests available now are the followings

Test Name:                                                                                            Price J.D

Alpha 1 Antitrypsin                                                                                   170

Hemochromatosis                                                                                      120

Medium Chain Acyl � CoA Dehydrogenase ( MCAD )                               170

HCV typing PCR and Sequencing analysis                                                 120

APC mutation analysis (Familial AdenoPolyposis)                                     320

MSH2 or MLH1 mutation analysis                                                          320 each

(Hereditary Non-Polyposis Colon Cancer)

 

:That is in addition to the already available tests in our lab for

(HCV (quantitative and qualitative

(HBV DNA (quantitative and qualitative

 

We, in the First Medical Laboratory , are determined to bring the best of laboratory medicine in clinical practice to Jordan

Please call us for any further information

.Dr. Hussam Abu-Farsakh, M.D

American boards of Anatomic, clinical pathology & Cytopathology

infectious

(Mycobacterium tuberculosis (by PCR

Epstein Barr EA Ab Please find our infectious diseases panel that is present in our lab. The ones in bold are new tests. Please contact our lab for any inquiries
Mycoplasma pneumoniae Ab Epstein Barr Nuclear antigen Ab  
Mycoplasma hemolyticum Ab Epstein Barr Virus Capsid Ab  
Parainnfluenza virus 1-4 A                                  Filaria, Blood smear  
Respiratory syncytial virus Ab Giardia lamblia Antigen Adenovirus antigen
Respiratory syncytial virus Ag Helicobacter Ab Adenovrius by PCR
Rotavirus Ag in stool Hemophilus influenza Ab            Adenovirus Ab
Rubella Ab Hepatitis A Total Ab     Ascaris Ab
Schistosoma Ab�s Hepatitis B core Ab IgM Aspergillous IgG, IgM
Spirochetes immunostaining Hepatitis B e Ab Bilahrazia Ab
Strongyloides Ab�s Hepatitis B e Ag Bordetella parapertussis Ab
Tick-borne encephalitis (TBE) Hepatitis B surface Ab Bordetella pertussis Ab
Toxocara canis IgG Hepatitis B surface Ag Borrelia afzelii Ab
(Toxoplasma (IgG/ IgM Hepatitis B Virus (by PCR (Borrelia burgdorferi sensu stricto (CH
Toxoplasma immunostaining Hepatitis C Ab Borrelia garinii Ab        
Trepenoma Pallidum Hepatitis C Virus genotyping Brucella abortus, melitensis Ab
Trypanosoma cruzi IgG (Hepatitis Delta (HDV Brucella Abs IgG, IgM
Tuberculosis IgG, IgM Hepatitis E, Ab Candida Albicans Ab
Tuberculosis in fluid(patho-TB) (Hepatits C Virus (by PCR Chlamydia pneumonia Ag
Uroplasma ureylticum Ab Herpes simplex (1 &II), IgG,M (by PCR and by Direct IF)
(Varicella Zoster (G/M Herpes simplex glycoprotein by western blot Chlamydia pneumoniae Ab
VDRL                        Herpes simplex immunostaining CMV buffy coat        
West Nile Valley (Flavivirus) IgM HIV 1-2           Ab CMV IgG, IgM
Yersinia entercolitica O:3,6,9 HIV-1-RNA by PCR Compylobacter coli Ab
  Human papilloma virus immunostaining Compylobacter jejuni Ab
  Human papilloma virus PCR genotypes 6,11,16,18,31,31b,33, 5 3,56,58,59,61 Coxsackie virus A Ab  
  Influenza A virus , Ab Coxsackie virus B1-6, Ab
  Influenza B virus, Ab Cryptococcus antigen           
  Klebsiella pneumonia, Ab            (Cryptosporidium Antigen (stool
  Legionella pneumonia serotypes Ab Dengue virus
We are committed in First medical lab to bring the best of laboratories test to clinical practice in Jordan. Legionella pneumonia antigen in urine and BAL            Echinococcus Ab
  Leptospira IgG Echo virus type                        
Dr Hussam Abu-Farsakh Leshmania Ab Entamba Histolystica Ab�s

A Metastatic Tumor Of Unknown Primary, Is A Term Of The Past

Not uncommonly, we face a case of metastatic carcinoma in the lung, liver, bone or in the brain and the primary is not known. The search for the primary site may cost the patient a lot of time, effort and money by performing the various investigations. To cut these investigations short, we have made use of the advances made in Immunohistochemistry lately in discovering the many primary sites of carcinoma or sarcomas by performing a panel of immunohistochemical staining. This knowledge has a great impact on the treatment regimens on different metastatic malignant tumors

:For example

Thyroid tumors : Positive for Thyroglobulin and Thyroid Transcription Factor

Lung tumor: Positive for TTF-1

(Breast tumors: Positive for GCDFP-15 (in addition to Estrogen and progesterone receptors

Colorectal carcinoma: Positive for Cytokeratin 20 and negative for HMW cytokeratin

Mesothelioma: Positive for mesothelin and negative for CEA and TTF-1

(Hepatocellular carcinoma: Positive for alpha-fetoprotein , CD66e and CD 34 (in canilcular pattern

Vascular tumor: Positive for CD 34

Squamous cell carcinoma: Positive for HMW Cytokeratin and negative for LMW Cytokeratin

(Prostate carcinoma: Positive for Prostate Specific Antigen (PSA

Ovarian carcinoma: Positive for CA-125 and Cytokeratin 20

(Neuroendocrine tumor: Positive for Chromogranin, Synaptophysin, (in thyroid: positive for Calcitonin

Pancreatic carcinoma: Positive for CD66e , Cytokeratin 20 , Cytokeratin 7 and HMW Cytokeratin

Transitional cell carcinoma of the bladder: Positive for HMW Cytokeratin and Cytokeratin 20 but negative for CD66e

Rhabdomyosarcoma: Positive for Myo-D1

Renal cell carcinoma of the kidney: Positive for pancytokeratin, Negative for Cytokeratin 20 , CD66, and HMW Cytokeratin

Germ cell tumor: positive for B-HCG, PLAP and /or alpha feto-protein

All the above Immunostaining can be performed on Fine Needle Aspiration Cytology smears and on biopsy tissue sections

Now, in the first medical laboratory, we have all these wide range of immunophenotyping to detect any case of unknown primary

We, in the First Medical Laboratory, are dedicated to bring the best of laboratory medicine to clinical practice to Jordan

.Dr. Hussam Abu- Farsakh, M.D

American boards of Anatomic, Clinical Pathology and Cytopathology

 

Circular: is a periodic circular that distributed to clinician informing them about new and important tests available at First Medical Laboratory. All information listed are supported by recent literature

Adenomatous Polyposis Coli (APC) protein

Familial adenomatous polyposis (FAP) is an autosomal dominant inherited disease characterized by the presence of adenomatous polyps in the colon and rectum, with inevitable development of colorectal cancer if left untreated. FAP is caused by germline mutations in the adenomatous polyposis coli (APC) gene, with near 100% risk of development of colonic adenocarcinoma

APC gene is a tumor suppressor gene. This gene is responsible for coding for a large protein. This protein is very crucial for cell stability, integrity and important for cell to cell interaction. When this gene is mutated, it is responsible for Colorectal carcinoma. Colorectal carcinoma   is one of the cancers that can be genetically inherited. One of the inheritance ways of Colorectal carcinoma is through APC mutation. Germline mutation or delation of the APC gene located on Chromosome 5 (5q21) is the most common cause with an incidence of between 1:17,000 and 1:5,000. This is followed by somatic mutation in the process of adenoma-carcinoma sequences. The germline mutation is responsible for the development of familial adenomatous polyposis. Inactivation of the second allele is necessary for the development of the adenomatous polyposis which usually occurs as a deletion

APC inactivation is also present as a somatic mutation in about 70% of the sporadic adenomas and adenocarcinomas. The fact that APC gene abnormality can be found in most adenomas even of small size, indicates that this tumor suppressor gene plays a crucial role in the initiation of colonic carcinogenesis

 

:Test available at First Medical Lab

Immunohistochemistry: the product of APC inactivation is a large protein that can be expressed in adenoma-carcinoma polyps

Genetic testing for APC gene by PCR is recommended with family history of patient with colon carcinoma

We, in the First Medical Laboratory , are determined to bring the best of laboratory medicine in clinical practice to Jordan

Please call us for any further information

.Dr. Hussam Abu-Farsakh, M.D

American boards of Anatomic, clinical pathology & Cytopathology

Anti-GAD and Diabetes

Antibodies against glutamic acid decarboxylase (anti-GAD) is very important test for the detection of type I diabetes mellitus or laten autoimmune diabetes in adult (i.e. slow or laten type I diabetes). Its detection in patients developing diabetes is very important as it is the �most important factor for prediction of insulin therapy within 3 years in young adult diabetic patients not classified as type I diabetes on clinical ground

Anti-GAD are associated with 70% in Type I diabetes patient and in 60% of �slow or laten type I diabetes�. It can be present with anti-insulin antibodies and / or anti-insulin antibodies. It can be the only antibody present in �slow onset diabetes type I �and can be the only predictor that these patient are going to be insulin dependent in the future

Performing anti- GAD in all diabetic patients is very important predictor to those that may require insulin therapy in the future

Material required: 2 cc of serum

 

We, in the First Medical Laboratory, are dedicated to bring the best of laboratory medicine to clinical practice to Jordan

Dr. Hussam Abu-Farsakh

American Board of Anatomic & Clinical Pathology, and Cytopathology


Circular: is a periodic circular that distributed to clinician informing them about new and important tests available at First Medical Laboratory. All information listed are supported by recent literature

Anti-ganglioside antibodies

:Introduction

Antibodies against ganglioside are found in various types of peripheral neuropathy. These include Guillain-Barrie’ syndrome, Miller Fisher syndrome (a variant of Guillain-Barrie’ with descending neuropathy). Also seen in Motor neuron disease and chronic inflammatory demyelinating polyneuropathy

:Test profile

:The following antibodies are examined

GM1  : Monosialoganglioside GM1

GM2  : Monosialoganglioside GM2

GM3  : Monosialoganglioside GM3

GD1a: Disialoganglioside GD1a

GD1b: Disialoganglioside GD1b

GT1b: Trisialoganglioside GT1b

GQ1b: Tetrasialoganglioside GQ1b

 

:Clinical significance

-1

Motor neuron disease associated with GM1, up to 70% of cases

-2

Guillain-Barrie’ syndrome associated with GM1 in up to 30% of cases, and with less frequency to GM3, GD1a, GD1b, GT1b and GQ1b

-3

Sensory neuropathy associated with GD1b

-4

Miller Fisher syndrome (a variant of Guillain-Barrie’ with descending neuropathy) associated with GQ1b in 90% of the cases

Material required: Serum*

 

We, in the First Medical Laboratory, are dedicated to bring the best of laboratory medicine to clinical practice to Jordan

Dr. Hussam Abu-Farsakh

American Board of Anatomic & Clinical Pathology, and Cytopathology

 

“Circular” is a periodic circular that distributed to clinician informing them about new and important tests available at First Medical Laboratory. All information listed are supported by recent literature

Antibodies against Cyclic Citrullinated Peptide (CCP) for Rheumatoid Arthritis

Rheumatoid factor (RF) is used to be for a long time the most commonly performed serological test in suspected rheumatoid arthritis (RA). These antibodies (predominantly of Class IgM) occur in 60-80% of RA patients. RF is a sensitive but not a very specific test for RA, since they can occur in healthy individual and in patients with various autoimmune diseases (SLE, Sjogren�s syndrome, scleroderma, etc

In recent years, it has been shown that rare amino acid citrulline which is present in filaggrin (a protein in the keratin of the epidermis linking keratin filaments to each other) is a substantial component of the antigenic epitope. Antibodies against cyclic citrullinated peptide (CCP) are a new and highly specific marker for RA

Antibodies against CCP are predominantly of class IgG and have much higher specificity of 97% for RA , compared to 62 % for RF. The sensitivity of 80%, on the other hand is similar to both tests. This test, in addition, can be detected in early stages of the disease in 79% of patients

 

Conclusion: anti-CCP is a new test with a very high specificity for Rheumatoid arthritis and a high sensitivity. It is now widely replacing �Rheumatoid Factor� as a diagnostic test for �Rheumatoid arthritis

 

We, in the First Medical Laboratory, are dedicated to bring the best of laboratory medicine to clinical practice to Jordan

Dr. Hussam Abu-Farsakh

American Board of Anatomic & Clinical Pathology, and Cytopathology

 

Circular: is a periodic circular that distributed to clinician informing them about new and important tests available at First Medical Laboratory. All information listed are supported by recent literature

ANTIBODIES IN NEUROLOGICAL DISEASE; DIAGNOSTIC SIGNIFICANCE

Auto-antibody against neurological organs are associated with different diseases. Their recognition is essential in their diagnosis

:Anti-Hu, Anti-Ri,Anti-Yo

Para-neoplastic syndrome: Neurological disorders secondary to malignancy can manifest in patients long time before their malignancy is discovered. Patients can manifest with Cerebellar ataxia, encephalomyelitis , myoclonus, or sensory neuropathy. Detection of neuronal antibody : Anti-Yo (antibody against Cerebellar Purkinje cells) , Anti-Hu, Anti-Ri (against neuron nuclei ) are strongly associated with this syndrome

:Anti-GAD

Stiff man syndrome: is a syndrome of diffuse hypertonia of the muscles due to loss of inhibitory spinal interneurons associated with anti-GAD antibodies (Glutamic Acid decarboxylase). GAD are receptors in the cerebellum and other neurological organs

Amyotrophic lateral sclerosis can also be associated with anti-GAD

Cerebellar degeneration outside the context of para-neoplastic syndrome is associated with anti-GAD

:Anti-Myelin Antibody

Multiple sclerosis: Antibodies against myelin: can be associated with multiple sclerosis

:Anti-MAG

(Guillain Barre syndrome : is associated with myelin-associated glycoprotein (anti-MAG

These tests are performed at the First Medical Laboratory from serum of affected patients

 

We, in the First Medical Laboratory, are dedicated to bring the best of laboratory medicine to clinical practice to Jordan

Dr. Hussam Abu-Farsakh

American Board of Anatomic & Clinical Pathology, and Cytopathology

 

Circular: is a periodic circular that distributed to clinician informing them about new and important tests available at First Medical Laboratory. All information listed are supported by recent literature

Apo E, Lipid Disorders and Coronary Artery Disease

Introduction: Apo E mediates removal of chylomicron and VLDL remnants from plasma by binding these particles to LDL. Three different alleles are present for Apo E E2, E3, E4

Types of Apo E and clinical significance: ApoE3/E3 are present in about 77% of the total population and is the normal variant. Apo E3 is fully functioning and is associated with decreased plasma cholesterol levels. In contrast, Apo-E4 is present in 10-15% of the population, associated with increased cholesterol level and development of premature atherosclerosis. This genotype is associated with coronary artery disease. ApoE-4 still had an increased risk of heart disease, even if the patient�s cholesterol level and blood pressure were normal. Apo E-4 is associated strongly with Alzheimer�s disease, with patients having both alleles have an earlier onset than patients with one

Was sooo didn’t canadian pharmacy colors fingers it is product canadian pharmacy pieces think conditioner clumpy week.

allele. One the other hand, Apo E2/E2 genotype is associated with familial dysbetalipoproteinemia (Type III hyperlipidemia ) with increased plasma cholesterol and Triglycerides. It is associated with accelerated arteriosclerosis , coronary heart disease and peripheral vascular disease

:(Indication for apo E genotype testing (either one

-1

Total serum cholesterol>240 mg/dl and Triglycerides >150 mg/dl

-2

(LDL cholesterol > (age of the patient + 100) and TG > (Age of the patient +100

-3

VLDL revealed by lipoprotein electrophoresis as broad beta band

Conclusion : Apo-E polymorphism is a major determinant of risk for the development of atherosclerotic vascular disease and coronary artery disease

We in the First Medical Lab are dedicated to bring the best of Laboratory medicine to clinical practice in Jordan

Dr. Hussam Abu-Farsakh

American Board of Anatomic & Clinical Pathology, and Cytopathology

Circular: is a periodic circular that distributed to clinician informing them about new and important tests available at First Medical Laboratory. All information listed are supported by recent literature